by Gabriel Levitt, President, PharmacyChecker.com and Prescription Justice | Dec 6, 2013 | Drug Prices, Healthcare Reform, Medicare Drug Plans
Your prescription drugs will never be free under Medicare Part D. The “closed” donut hole under Obamacare does not create a new coverage period under Part D during which your co-pays and co-insurance, not to mention deductibles and premiums, disappear. That’s not a reason to complain. We should shoulder costs for our healthcare, including medication, as long as they are affordable (after all, Obamacare is actually called the Affordable Care Act). So how does Obamacare strive to help you afford your prescription drugs if you’re on Medicare? First, a little history…
In the beginning, Medicare did not offer a prescription drug benefit and tens of millions of seniors paid for their medications entirely out-of-pocket. Let there be light: In 2003, Congress passed the Medicare Modernization Act, which was then signed into law by President Bush. That law gave birth to Part D – a prescription drug benefit available to Medicare enrollees. But there were holes! When Medicare Part D plans first launched in 2006, average monthly premiums were $25.93. After paying a standard deductible of $250, enrollees paid 25% of their drug costs until total drug costs (between the enrollee and insurer) reached $2,250. That’s $250 towards the deductible, $500 in cost-sharing, plus premiums of $311.16 for a total of $1,061.16 per year in out-of-pocket spending. That’s if you stayed out of the donut hole!
Enter the dark days of the “donut hole,” which, in 2006, meant 100% out-of-pocket spending between $2,250 and $5,100 – Ouch! Above $5,100 – an amount called, for good reason, “catastrophic costs” –enrollees only paid 5% of their drug costs. Part D maintained these basic components, except with rising costs in the form of higher premiums and deductibles, and a larger “donut hole,” until the passage of the Patient Protection and Affordable Care Act in 2010 – enter Obamacare (hope and change?).
(more…)
Tagged with: donut hole, Medicare Part D, Obamacare
by PharmacyChecker.com | Oct 30, 2013 | Medicare Drug Plans
As we wrote a few weeks ago, there are loads of changes coming to Medicare Part D next year. Changes to your plan’s deductible and monthly premium can impact your wallet, for better or for worse! We’ve analyzed the plans from 2013 and 2014 and identified those with notable changes to their deductibles and premiums.
Keep in mind that there may be other important changes to a plan, such as those to its formulary or cost sharing structure. For example, the deductible for Blue MedicareRx Value plan double in 2014, and it is also losing about 700 drugs from its formulary. On the other hand, this plan and others might see increases in deductibles or premiums correspond with lower co-pays or better donut hole coverage, which could save you a lot of money.
The tables below show you examples of plans with large changes, and aren’t meant to be comprehensive. To view more plan options, and read reviews and ratings by members, head over to MedicareDrugPlans.com.
Notable Decreases in Plan Deductibles
| Plan Name |
States |
2013 Deductible |
2014 Deductible |
Dollar Change |
% Change |
|
Express Scripts Medicare – Choice (PDP)
|
Many States |
$200 |
0 |
-$200 |
-100% |
| Health Alliance Medicare Prescription Plan – Enhcd (PDP)
|
Illinois |
$325 |
0 |
-$325 |
-100% |
| United American – Enhanced (PDP) |
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, Wyoming, |
$40
|
$20 |
-$20 |
-50% |
Notable Increases in Deductible
| Plan Name |
States |
2013 Deductible |
2014 Deductible |
Dollar Change |
% Change |
| Blue MedicareRx Value (PDP)
|
Arizona |
$150 |
$310 |
$160 |
107 % |
| Prescription Blue Option A (PDP)
|
Michigan |
$125 |
$195 |
$70 |
56% |
| Blue Rx Plus (PDP)
|
Pennsylvania, West Virginia |
$250 |
$310 |
$60 |
24% |
Notable Decreases in Monthly Premiums
| Plan Name |
States |
2013 Premium |
2014 Premium |
Dollar Change |
% Change |
| WellCare Classic (PDP)
|
Mississippi |
$36.60 |
$17.30 |
-$19.30 |
-53% |
| Aetna Medicare Rx Essentials (PDP)
|
Oregon, Washington |
$72.90 |
$35.20 |
-$37.70 |
-52% |
| Express Scripts Medicare – Choice (PDP) |
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota |
$102.70 |
$70.60 |
-$32.10 |
-31% |
Notable Increases in Monthly Premiums
| Plan Name |
States |
2013 Premium |
2014 Premium |
Dollar Change |
% Change |
| Aetna CVS/pharmacy Prescription Drug Plan (PDP)
|
Florida |
$32.50 |
$75.00 |
$42.50 |
131% |
| AARP MedicareRx Saver Plus (PDP)
|
Oregon, Washington |
$15 |
$29.50 |
$14.50 |
97% |
| First Health Part D Value Plus (PDP)
|
Colorado |
$32.30 |
$58.40 |
$26.10 |
81% |
Once again, you need to shop around and do your research to get the best plan. Check out some reviews and ratings at MedicareDrugPlans.com – and rate your current plan to help others – then head over to the government’s site www.medicare.gov to compare plan formularies, and choose a plan that covers the medications you take.
Tagged with: 2014, deductibles, Medicare Drug Plans, Medicare Part D, premiums
by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | Oct 11, 2013 | Medicare Drug Plans
October 15th is just around the corner, which means that it’s time for open enrollment for Medicare Part D drug plans. If you are eligible and want to sign up for or change your plan, you have until December 7th to do so.
Comparing plans is no easy task. First, you need to consider a plan’s drug coverage to make sure it covers the meds you take, and then its costs. Then there are monthly premiums and deductibles. And then there’s the stuff you can’t figure out based only on numbers: Is your plan accepted at your local pharmacy? Do you need to use a mail order pharmacy? How is the customer service?
Luckily, our sister site MedicareDrugplans.com can help you evaluate those questions. It lets you compare deductibles, monthly premiums, and coverage during the “donut hole”. More importantly, you can look at drug plan reviews and ratings written by your peers, which can reveal more subtle problems with plans, such as poor wait times for customer service, unexpected formulary changes, or dissatisfaction with mail-order pharmacy options.
For some examples, read what consumers in Florida are saying in Florida about the AARP MedicareRx Enhanced plan:
2011: “Medication I need was suddenly pulled from the formulary and AARP won’t even consider it with doctor’s intervention. They care less about patient care and more about the bottom line.”
2012: “The co-pay is more than what I would pay with plain medicare.”
2013: “Takes too long to get prescriptions from mail order; too many additional authorizations from doctors who are too busy to deal with this extra paperwork.”
Please know that these are just a few examples of reviews and that some people may have benefited greatly from this plan. It could be no worse than most others and better than some, but the complaints are representative of those we’ve found written about many plans.
Once you’ve viewed ratings and reviews, and even written one yourself, head over to Medicare.gov to make sure the plan covers your meds, compare final costs, and then sign up for the right plan. The average premium nationally is $53.80, and the maximum annual deductible is $310, down $15 from last year.
Research and choose your plan carefully. Whatever plan you go with will start January 1st, 2013 and last for a full year – so make it the right one for you! Visit MedicareDrugPlans.com today.
Tagged with: Medicare Part D
